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https://swslhd.intersearch.com.au/swslhdjspui/handle/1/1276| Title: | The costs, health outcomes and cost-effectiveness of interventions for the prevention and treatment of incontinence-associated dermatitis: A systematic review |
| Authors: | Cunich, M. Barakat-Johnson, M. Lai, M. Arora, S. Church, J. Basjarahil, S. Campbell, J. L. Disher, G. Geering, S. Ko, N. Leahy, C. Leong, T. McClure, E. O'Grady, M. Walsh, J. White, K. Coyer, F. |
| Affiliates: | Charles Perkins Centre, Faculty of Medicine and Health (Central Clinical School), The University of Sydney, Sydney, NSW 2006, Australia Sydney Institute for Women, Children and their Families, Sydney Local Health District (SLHD), Sydney, NSW, Australia The ANZAC Research Institute, Concord Repatriation General Hospital, Concord, NSW, Australia Sydney Health Economics Collaborative, Sydney Local Health District (SLHD), Sydney, NSW, Australia Nursing and Midwifery Executive Services, Sydney Local Health District (SLHD), Sydney, NSW, Australia Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia Centre for Healthcare Transformation, Queensland University of Technology (QUT), Brisbane, QLD, Australia Centre for Health Economics Research and Evaluation (CHERE), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia Nursing and Midwifery Services, The Sutherland Hospital, South Eastern Sydney Local Health District, Sydney, NSW, Australia Nursing and Midwifery Services, Hunter New England Local Health DistrictNSW, Australia Strategic Reform and Planning Branch, New South Wales Ministry of Health, Sydney, NSW, Australia Nursing and Midwifery Services, South Western Sydney Local Health District, Sydney, NSW, Australia Nursing and Midwifery Services, Concord Repatriation General Hospital, Sydney Local Health District, Sydney, NSW, Australia Quality, Clinical Safety and Nursing, Western New South Wales Local Health DistrictNSW, Australia Nursing and Midwifery Services, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia Aged and Chronic Care and Rehabilitation Services, Sydney Local Health District, Sydney, NSW, Australia Cancer Care Research Unit, Sydney Local Health DistrictNSW, Australia The Daffodil Centre, The University of Sydney, a Joint Venture with Cancer Council NSWNSW, Australia Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia School of Nursing, Queensland University of Technology (QUT), Brisbane, QLD, Australia |
| Issue Date: | 2022 |
| Journal: | International Journal of Nursing Studies |
| Abstract: | Background: Incontinence-associated dermatitis is a common, under-recognized painful skin condition associated with poorer quality of life, increased nurse workloads, and costs. Objective: To systematically review economic evidence for the prevention and treatment of incontinence-associated dermatitis. Design: Systematic review of quantitative research. Data sources: PubMed, MEDLINE, EMBASE, Cochrane Library, York Centre for Reviews and Dissemination database, Econlit, Tufts? Cost-Effectiveness Analysis Registry, and Web of Science. Review methods: A comprehensive search for studies on resource use (costs), health outcomes, and cost-effectiveness of interventions for incontinence-associated dermatitis was conducted. Screening, data extraction, and initial quality assessment were conducted independently by two reviewers, with disagreements/queries regarding quality settled through consensus with the larger team. Quality evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist and results narratively arranged. Findings: Seventeen studies (10 for prevention, one for treatment and six for both prevention and treatment) included. All studies measured resource use from a healthcare provider perspective; 14 quantified resources in monetary terms. Considerable variation existed in the resource use data primarily due to differences in the type of resources counted, selected time horizons, valuation methods, and reporting approaches. Ten studies provided evidence of their intervention to be cost saving (or at least cost avoiding). Five studies on barrier products provided evidence to be cost saving: three for prevention, one for treatment, and one for both prevention and treatment. Two studies of cleanser and barrier products provided evidence to be cost saving for the prevention and treatment of incontinence-associated dermatitis. One study found a cleanser to be a cost saving preventative intervention. One bowel management system was found to be cost saving over time only, and one nurse education intervention was found to be cost saving for preventing and treating incontinence-associated dermatitis. One barrier product was found to be cost-effective for preventing and treating the condition. Finally, one study found a cleanser and barrier product was time saving for prevention. None of the studies incorporated a multi-attribute quality of life measure; however, two studies included person-reported outcome measures for pain. A narrow range of resources (mainly products) were considered, and there was limited information on how they were counted and valued. Analyses relating to heterogeneity among patients/hospital wards or health facilities and uncertainty were lacking. Conclusions: Barrier products are possibly a more cost-effective treatment than others; however, this evidence lacks certainty. Structured health economic evaluations are required for a reliable evidence-base on the interventions for incontinence-associated dermatitis. Tweetable abstract: Most incontinence-associated dermatitis studies lack person-reported outcomes, costs beyond product/staff time, and economic evaluation. ? 2022 |
| URI: | https://swslhd.intersearch.com.au/swslhdjspui/handle/1/1276 |
| Digital object identifier: | 10.1016/j.ijnurstu.2022.104216 |
| Appears in Collections: | South Western Sydney Local Health District |
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